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| Analysis of risk factors and prognosis of anterior communicating artery aneurysm complicated with intraventricular hemorrhage in the elderly |
| ZHOU Jiafeng1, CHEN Yongchun1, LIN Boli1, CHEN Lifang1, XIONG Ye2, YANG Yunjun1 |
| 1.Department of Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China; 2.Department of Neurosurgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China. |
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| Cite this article: |
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ZHOU Jiafeng,CHEN Yongchun,LIN Boli, et al. Analysis of risk factors and prognosis of anterior communicating artery aneurysm complicated with intraventricular hemorrhage in the elderly[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2020, 50(8): 652-656，661.
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Abstract Objective: To investigate the risk factors and prognosis of intracerebral and/or intraventricular hematoma (ICH and/or IVH) after rupture of AComA (anterior communicating artery) aneurysms in elderly and young patients. Methods: From December 2007 to January 2016, a total of 285 consecutive patients suffering from ruptured AComA aneurysms with ICH and/or IVH that admitted to the department of neurosurgery in the First Affiliated Hospital of Wenzhou Medical University, had been enrolled into this retrospective study. Among them, 172 patients underwent clipping, 244 patients underwent Coiling, and 64 patients underwent medical treatment. Patients were divided into two groups based on age:patients of age≤60 years (n=168) and patients of age>60 years (n=117). All patients had been examined by CT angiography (CTA) before surgery and the morphological parameters of the aneurysm had been measured. Single and multiple variate logistic regression methods were used to analyze the risk factors and prognosis of ruptured AComA aneurysms with ICH and/or IVH in elderly and young. Results: The univariate analysis revealed that the two groups had statistically significant differences in the gender, hypertension history, smoking history, vessel angle, flow angle, treatment and GOS score (all P<0.05). The multivariate analysis revealed that hypertension history (OR=1.858, 95%CI=1.083-3.188, P=0.025), flow angle (OR=1.016, 95%CI=1.004-1.028, P=0.010) and treatment (coiling vs. medical treatment OR=0.209, 95%CI=0.088-0.497, P<0.001; clipping vs. medical treatment OR=0.233, 95%CI=0.101-0.541, P=0.001) were closely associated with elderly patients of ruptured AComA aneurysms with ICH and/or IVH. The prognosis analysis of different treatment methods in the elderly group had showed that the prognosis of patients receiving surgical treatment was relatively good (coiling vs. medical treatment OR=0.134, 95%CI=0.049-0.362, P<0.001; clipping vs. medical treatment OR=0.308, 95%CI=0.116-0.820, P=0.018). Conclusion: Hypertension and bigger flow angle are the risk factors of ICH and/or IVH induced by ruptured AComA aneurysms, which is more obvious in the elderly. The operation rate of the elderly group is significantly lower than that of the young group, but the elderly patients after surgical treatment still has a better prognosis.
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